Figure 1

Preoperative photo and radiograph when patient came to the clinic.

Figure 2

Removed fragment of the fractured tooth. Fracture line was located 3 mm under CEJ. CEJ, cementoenamel junction.

Figure 3

Papilla preservation flap was reflected for crown reattachment procedure. Fracture line was extended to the equigingival area.

Figure 4

Adaptation of the modified fragment using premade putty index. Margin of the coronal fragment was trimmed off and it is short from the bone margin.

Figure 5

Rubber dam was placed with #211 clamp and fiber post was inserted (a). Coronal fragment was cemented with Duolink (b).

Figure 6

Fracture line was covered by composite resin with external chamfer preparation due to strengthening the cemented fragment.

Figure 7

6 month later, patient came back due to accidental fracture during mastication.

Figure 8

Coronal fragment was re-cemented without flap reflection.

Figure 9

2-year follow up photo. Slight discoloration and marginal gingivitis was found, but probing depth is normal.

Figure 10

2-year follow up radiograph.

Figure 11

Fracture pattern (From Dean, Avery and Swartz, Pediatric Dentistry 1986).

This case report was awarded in the 133rd spring scientific meeting of KACD in 2010 and supported for the publication by KACD.

Figure 1

Preoperative photo and radiograph when patient came to the clinic.

Figure 2

Removed fragment of the fractured tooth. Fracture line was located 3 mm under CEJ. CEJ, cementoenamel junction.

Figure 3

Papilla preservation flap was reflected for crown reattachment procedure. Fracture line was extended to the equigingival area.

Figure 4

Adaptation of the modified fragment using premade putty index. Margin of the coronal fragment was trimmed off and it is short from the bone margin.

Figure 5

Rubber dam was placed with #211 clamp and fiber post was inserted (a). Coronal fragment was cemented with Duolink (b).

Figure 6

Fracture line was covered by composite resin with external chamfer preparation due to strengthening the cemented fragment.

Figure 7

6 month later, patient came back due to accidental fracture during mastication.

Figure 8

Coronal fragment was re-cemented without flap reflection.

Figure 9

2-year follow up photo. Slight discoloration and marginal gingivitis was found, but probing depth is normal.

Figure 10

2-year follow up radiograph.

Figure 11

Fracture pattern (From Dean, Avery and Swartz, Pediatric Dentistry 1986).

REFERENCES

• 1. Andreasen FM, Noren JG, Andreasen JO, Engelhardtsen S, Lindh-Stromberg U. Long-term survival of fragment bonding in the treatment of fractured crowns: a multicenter clinical study. Quintessence Int. 1995;26: 669-681.PubMed
• 2. Farik B, Munksgaard EC, Kreiborg S, Andreasen JO. Adhesive bonding of fragmented anterior teeth. Endod Dent Traumatol. 1998;14: 119-123.ArticlePubMed
• 3. Reis A, Loguercio AD, Kraul A, Matson E. Reattachment of fractured teeth: a review of literature regarding techniques and materials. Oper Dent. 2004;29: 226-233.PubMed
• 4. Andreasen JO, Andreasen FM, Andersson L. Textbook and color atlas of traumatic injuries to the teeth. 2007;4th ed. Copenhagen, Denmark: Munksgaard; 314-336.
• 5. Reis A, Francci C, Loguercio AD, Carrilho MR, Rodriques Filho LE. Re-attachment of anterior fractured teeth: Fracture strength using different techniques. Oper Dent. 2001;26: 287-294.PubMed
• 6. Loguercio AD, Mengarda J, Amaral R, Kraul A, Reis A. Effect of fractured or sectioned fragments on the fracture strength of different reattachment techniques. Oper Dent. 2004;29: 295-300.PubMed
• 7. Pusman E, Cehreli ZC, Altay N, Unver B, Saracbasi O, Ozgun G. Fracture resistance of tooth fragment reattachment: effects of different preparation techniques and adhesive materials. Dent Traumatol. 2010;26: 9-15.ArticlePubMed
• 8. Grossmann Y, Araúz-Dutari J, Chogle SM, Blatz MB, Sadan A. A conservative approach for the management of a crown-root fracture. Quintessence Int. 2006;37: 753-759.PubMed
• 9. Ertugrul F, Eden E, Ilgenli T. Multidiciplinary treatment of complicated subgingivally fractured permanent central incisors: two case reports. Dent Traumatol. 2008;24: e61-e66.ArticlePubMed
• 10. Padbury A Jr, Eber R, Wang HL. Interactions between the gingiva and the margin of restorations. J Clin Periodontol. 2003;30: 379-385.ArticlePubMedPDF
• 11. Eichelsbacher F, Denner W, Klaiber B, Schlagenhauf U. Periodontal status of teeth with crown-root fractures: results two years after adhesive fragment reattachment. J Clin Periodontol. 2009;36: 905-911.ArticlePubMed
• 12. Olsburgh S, Jacoby T, Krejci I. Crown fractures in the permanent dentition: pulpal and restorative considerations. Dent Traumatol. 2002;18: 103-115.ArticlePubMedPDF
• 13. Frantz BJ, Polson AM. Tissue interactions with dentin specimens after demineralization using tetracycline. J Periodontol. 1988;59: 714-721.ArticlePubMed
• 14. Lowenguth RA, Polson AM, Caton JG. Oriented cell and fiber attachment systems in vivo. J Periodontol. 1993;64: 330-342.ArticlePubMedPDF
• 15. Dean JA, Avery DR, Swartz ML. Attachment of anterior tooth fragments. Pediatr Dent. 1986;8: 139-143.PubMed
• 16. Stellini E, Stomaci D, Stomaci M, Petrone N, Favero L. Fracture strength of tooth fragment reattachments with postpone bevel and overcontour reconstruction. Dent Traumatol. 2008;24: 283-288.ArticlePubMed

Tables & Figures

Figure 1

Preoperative photo and radiograph when patient came to the clinic.

Figure 2

Removed fragment of the fractured tooth. Fracture line was located 3 mm under CEJ. CEJ, cementoenamel junction.

Figure 3

Papilla preservation flap was reflected for crown reattachment procedure. Fracture line was extended to the equigingival area.

Figure 4

Adaptation of the modified fragment using premade putty index. Margin of the coronal fragment was trimmed off and it is short from the bone margin.

Figure 5

Rubber dam was placed with #211 clamp and fiber post was inserted (a). Coronal fragment was cemented with Duolink (b).

Figure 6

Fracture line was covered by composite resin with external chamfer preparation due to strengthening the cemented fragment.

Figure 7

6 month later, patient came back due to accidental fracture during mastication.

Figure 8

Coronal fragment was re-cemented without flap reflection.

Figure 9

2-year follow up photo. Slight discoloration and marginal gingivitis was found, but probing depth is normal.

Figure 10

2-year follow up radiograph.

Figure 11

Fracture pattern (From Dean, Avery and Swartz, Pediatric Dentistry 1986).

Figure 1

Preoperative photo and radiograph when patient came to the clinic.

Figure 2

Removed fragment of the fractured tooth. Fracture line was located 3 mm under CEJ. CEJ, cementoenamel junction.

Figure 3

Papilla preservation flap was reflected for crown reattachment procedure. Fracture line was extended to the equigingival area.

Figure 4

Adaptation of the modified fragment using premade putty index. Margin of the coronal fragment was trimmed off and it is short from the bone margin.

Figure 5

Rubber dam was placed with #211 clamp and fiber post was inserted (a). Coronal fragment was cemented with Duolink (b).

Figure 6

Fracture line was covered by composite resin with external chamfer preparation due to strengthening the cemented fragment.

Figure 7

6 month later, patient came back due to accidental fracture during mastication.

Figure 8

Coronal fragment was re-cemented without flap reflection.

Figure 9

2-year follow up photo. Slight discoloration and marginal gingivitis was found, but probing depth is normal.

Figure 10

2-year follow up radiograph.

Figure 11

Fracture pattern (From Dean, Avery and Swartz, Pediatric Dentistry 1986).

REFERENCES

• 1. Andreasen FM, Noren JG, Andreasen JO, Engelhardtsen S, Lindh-Stromberg U. Long-term survival of fragment bonding in the treatment of fractured crowns: a multicenter clinical study. Quintessence Int. 1995;26: 669-681.PubMed
• 2. Farik B, Munksgaard EC, Kreiborg S, Andreasen JO. Adhesive bonding of fragmented anterior teeth. Endod Dent Traumatol. 1998;14: 119-123.ArticlePubMed
• 3. Reis A, Loguercio AD, Kraul A, Matson E. Reattachment of fractured teeth: a review of literature regarding techniques and materials. Oper Dent. 2004;29: 226-233.PubMed
• 4. Andreasen JO, Andreasen FM, Andersson L. Textbook and color atlas of traumatic injuries to the teeth. 2007;4th ed. Copenhagen, Denmark: Munksgaard; 314-336.
• 5. Reis A, Francci C, Loguercio AD, Carrilho MR, Rodriques Filho LE. Re-attachment of anterior fractured teeth: Fracture strength using different techniques. Oper Dent. 2001;26: 287-294.PubMed
• 6. Loguercio AD, Mengarda J, Amaral R, Kraul A, Reis A. Effect of fractured or sectioned fragments on the fracture strength of different reattachment techniques. Oper Dent. 2004;29: 295-300.PubMed
• 7. Pusman E, Cehreli ZC, Altay N, Unver B, Saracbasi O, Ozgun G. Fracture resistance of tooth fragment reattachment: effects of different preparation techniques and adhesive materials. Dent Traumatol. 2010;26: 9-15.ArticlePubMed
• 8. Grossmann Y, Araúz-Dutari J, Chogle SM, Blatz MB, Sadan A. A conservative approach for the management of a crown-root fracture. Quintessence Int. 2006;37: 753-759.PubMed
• 9. Ertugrul F, Eden E, Ilgenli T. Multidiciplinary treatment of complicated subgingivally fractured permanent central incisors: two case reports. Dent Traumatol. 2008;24: e61-e66.ArticlePubMed
• 10. Padbury A Jr, Eber R, Wang HL. Interactions between the gingiva and the margin of restorations. J Clin Periodontol. 2003;30: 379-385.ArticlePubMedPDF
• 11. Eichelsbacher F, Denner W, Klaiber B, Schlagenhauf U. Periodontal status of teeth with crown-root fractures: results two years after adhesive fragment reattachment. J Clin Periodontol. 2009;36: 905-911.ArticlePubMed
• 12. Olsburgh S, Jacoby T, Krejci I. Crown fractures in the permanent dentition: pulpal and restorative considerations. Dent Traumatol. 2002;18: 103-115.ArticlePubMedPDF
• 13. Frantz BJ, Polson AM. Tissue interactions with dentin specimens after demineralization using tetracycline. J Periodontol. 1988;59: 714-721.ArticlePubMed
• 14. Lowenguth RA, Polson AM, Caton JG. Oriented cell and fiber attachment systems in vivo. J Periodontol. 1993;64: 330-342.ArticlePubMedPDF
• 15. Dean JA, Avery DR, Swartz ML. Attachment of anterior tooth fragments. Pediatr Dent. 1986;8: 139-143.PubMed
• 16. Stellini E, Stomaci D, Stomaci M, Petrone N, Favero L. Fracture strength of tooth fragment reattachments with postpone bevel and overcontour reconstruction. Dent Traumatol. 2008;24: 283-288.ArticlePubMed

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